<form id="frmModal" name="frmModal" action="<?php echo site_url(array('psdm','propinsi','ajax','save')) ?>" method="post">
<h3 class="dialog_title"><span>Add Propinsi</span></h3>
<div class="dialog_content">
<div style="border-bottom: 1px solid #CCC; padding: 10px 0" >
<table width="100%" border="0" cellpadding="5" cellspacing="0">
	<tr>
		<td align="right" width="35%">Kode Propinsi:</td>
		<td><input type="text" name="inp[0]" maxlength="4" class="validate['required','%checkID']"></td>
	</tr>
	<tr>
		<td align="right">Nama:</td>
		<td><input type="text" name="inp[1]" maxlength="20" class="validate['required']"></td>
	</tr>
</table>
</div>
<div class="dialog_buttons" style="padding: 12px 10px">
	<input class="button" type="submit" value="Save"  />
	<input class="button" type="button" value="Cancel" onclick="FBModal_hide()" />
</div>
</div>
</form>